两孔法腹腔镜辅助脑室腹腔分流术的临床应用

Clinical application of ventriculoperitoneal shunt assisted by laparoscope in two holes

目的比较两孔法腹腔镜辅助脑室腹腔分流术(ventriculoperitonealshunt,VPS)和常规VPS的临床疗效,探讨两孔法腹腔镜辅助下VPS的临床应用经验。方法回顾性总结分析16例两孔法腹腔镜辅助VPS和42例常规VPS的临床资料,分析比较两种手术方式的腹部并发症的发生率。结果常规VPS组42例中6例出现腹腔端分流管梗阻,4例出现术后感染。两孔法腹腔镜辅助VPS组16例患者术后均恢复良好,症状均有不同程度的缓解,全部采用右肝膈间隙分流术,除1例感染外,无腹腔端分流管梗阻、移位、扭曲、堵塞,且无与腹腔镜手术相关的并发症发生。结论两孔法腹腔镜辅助脑室腹腔分流术安全可靠,具有创伤小、定位准、术后并发症少、术后恢复快等优点,具有良好的临床推广应用前景。

[Objective] To compare clinical effectiveness of ventriculoperitoneal shunt （VPS） assisted by laparoscope in two holes versus the clinical effectiveness of VPS via traditional operation in treating hydrocephalus. [Methods] The clinical data on 16 cases of VPS assisted by laparoscope in two hole and on 42 cases of VPS via traditional operation were summarized and analyzed retrospectively. The operation efficacy and the complication rate were compared between the two groups. [Results] In the traditional group, there were 6 cases of peritoneal catheter obstruction or displacement, 4 cases of postoperative infection. But in the laparoscope group, there was only one case of postoperative infection. Postoperatively the laparoscope group was better than the traditional group in respect to the postoperative outcome, complication rate and the clinical improvement. The total cases were treated by the VPS using right liver-diaphragm interspace drainage in the laparoscope group. [Conclusion] The technique of VPS assisted by laparoscope in two holes is safe, reliable, and has the advantages of accurate positioning, minimal injury and less postoperative complications; it is worthy of clinical application and popularization.